Late Behavior of Arterial Grafts: Three- to Five-Year Follow up of Homografts and Synthetic Prostheses in Experimental Animals

[Demonstration of neo-intima in PTFE-prostheses after venous replacement in dogs]

Because of the danger of thrombosis, venous replacement by prostheses is a yet clinically unsolved problem. We tested the PTFE-prosthesis at the positions of vena cava inferior and iliac veins in dogs. Already eight weeks after operation, the inner surface of the prosthesis was covered by a thin neo-intima, which by light microscopy, scanning and transmission electron microscopy was shown to contain a basal membrane and endothelial cells. This continuous layer may be responsible for the observed low rate of thrombosis. These findings suggest that the PTFE-prosthesis may offer advantages for venous replacement in patients.

Arterial homografts. Long term observation of results

In 29 consecutive cases of resection and aortic homograft replacement done between 1954 and 1958, the only surgical mortality occurred 14 days postoperatively and was due to a rupture of the implanted vessel.Seven patients have died (after a survival time averaging 21 months postoperatively) of causes not directly related to the aortic disease or to the operation.Twenty-one patients were still living some three to six and a half years after the implantation procedure-all of them active and showing no clinical evidence of aneurysmal dilatation. Infant thoracic aorta was used for homograft in the femoropopliteal area in three cases. Two of the patients were still living at the time of last report, four and five years after operation, with no evidence of obstruction or dilatation. This is perhaps indicative of the superiority of this material over plastic prosthesis for this purpose.